Provider Demographics
NPI:1811462534
Name:AMIT SHAH & AARTI PURI D.D.S INC
Entity type:Organization
Organization Name:AMIT SHAH & AARTI PURI D.D.S INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-674-8641
Mailing Address - Street 1:137 W CHAPMAN AVE STE A
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92832-1473
Mailing Address - Country:US
Mailing Address - Phone:714-738-6001
Mailing Address - Fax:
Practice Address - Street 1:31762 MISSION TRL # 1
Practice Address - Street 2:
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4545
Practice Address - Country:US
Practice Address - Phone:951-674-8641
Practice Address - Fax:951-674-8642
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMIT SHAH & AARTI PURI D.D.S INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty